Long-term opioid use among patients with chronic gout: a cross-sectional study of a sample cohort in South Korea
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ORIGINAL ARTICLE
Long-term opioid use among patients with chronic gout: a cross-sectional study of a sample cohort in South Korea Tak Kyu Oh 1 & In-Ae Song 1 Received: 8 February 2020 / Revised: 31 March 2020 / Accepted: 2 April 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Objectives This study aimed to determine trends in the prevalence of chronic opioid users among patients with chronic gout in South Korea from 2002 to 2015 and to investigate the factors associated with chronic opioid use among patients with chronic gout. Methods We performed a population-based cohort study and extracted data from the National Health Insurance Service database in South Korea. We included all adult patients (age ≥ 18 years) with a diagnostic code of M1A* (chronic gout) according to the International Classification of Disease (10th revision). Results The prevalence of chronic opioid users among patients with chronic gout has gradually increased from 4.0% in 2002 to 19.4% in 2015. After excluding the patients who had a history of cancer or other rheumatic diseases, a total of 18,042 patients with chronic gout were included in this cross-sectional cohort study in 2015, of which 993 (5.5%) were long-term opioid users. In a multivariable model, older age, female sex, Charlson Comorbidity Index > 2, long-term use of other analgesics, such as pregabalin, gabapentin, paracetamol, and glucocorticoids, and the use of other gout medication (colchicine) were independently associated with higher rates of long-term opioid use among patients with chronic gout. Conclusion Chronic opioid users among patients with chronic gout increased from 2002 to 2015 in South Korea. Female sex, older age, comorbid status, and the use of other non-opioid analgesics were independently associated with higher rates of longterm opioid use among patients with chronic gout. Key Points • Chronic opioid users among patients with chronic gout have increased from 2002 to 2015 in South Korea. • Among patients with chronic gout, 5.5% were long-term opioid users. • Female sex, older age, comorbid status, and the use of other non-opioid analgesics were associated with higher rates of long-term opioid use.
Keywords Gout . Outcome measures . Pain . Quality of life
Introduction Gout is a systemic disease that results from the deposition of monosodium urate crystals in the soft tissues and joints and accompanies hyperuricemia [1]. It is the most common type of inflammatory arthritis in men aged > 40 years [2]. Men are twice more likely to have gout than women [3]. Epidemiological data have indicated that the prevalence of
* In-Ae Song [email protected] 1
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam 463-707, South Korea
chronic gout is increasing [4]. In developed countries, it affects 1–2% of adults [5]. A recent study reported that the global burden of chronic gout has increased between 1990 and 2017 [6]; hence, it is an important global health issue. A
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